Stephen Leo

Individual provider Active NPI Driver · Closter, NJ

NPI 1386205367 · NPPES record last updated Jun 21, 2019

Key facts

NPI
1386205367
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
L26047220008592 (NJ)
Practice address
24 Westminster Ave
Closter, NJ 07624-1217
Phone
(201) 784-2039
NPI assigned
Jun 21, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L26047220008592NJMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X L26047220008592 NJ Yes

Addresses

Primary practice location

24 Westminster Ave
Closter, NJ 07624-1217

Mailing address

24 Westminster Ave
Closter, NJ 07624-1217
Phone (201) 784-2039

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address sleo@newyorklife.com

Other providers in Closter, NJ

All providers in Closter, NJ · Driver in New Jersey

Sources for this page

Verify at the official NPI Registry.